Department of Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio, USA.
Head Neck. 2011 Dec;33(12):1796-9. doi: 10.1002/hed.21476. Epub 2010 Jul 13.
Benign secondary neck lesions in the setting of laryngeal cancer have been described, but not with branchial cleft cysts. This article describes a branchial cleft cyst in a laryngectomy/neck dissection specimen.
A 44-year-old woman presented to our emergency department with an obstructing laryngeal tumor that was staged as a T4N0M0 squamous cell cancer on the basis of clinical and radiographic findings. After laryngectomy with bilateral neck dissections, the neck specimen contained a right-sided branchial cleft cyst, which was directly invaded by tumor. In addition, the location of the cyst relative to the larynx suggested that this was a third branchial cleft cyst.
This is the first report of a laryngeal carcinoma invading a branchial cleft cyst. Staging discrepancies may result from concurrent head and neck lesions, altering treatment plans, or changing the prognosis for the patient. Lesions such as this are nearly impossible to diagnose preoperatively, and a high index of suspicion for advanced cancer should be maintained.
喉癌患者颈部出现良性继发性病变已有描述，但鳃裂囊肿尚未报道。本文描述了一例喉癌全喉切除/颈清扫标本中的鳃裂囊肿。
一名 44 岁女性因喉部阻塞性肿瘤就诊，根据临床和影像学检查结果，肿瘤分期为 T4N0M0 期鳞状细胞癌。行全喉切除术和双侧颈清扫术，颈标本中发现右侧鳃裂囊肿，直接被肿瘤侵犯。此外，囊肿的位置与喉部的关系提示这是一个第三鳃裂囊肿。
这是首例喉癌侵犯鳃裂囊肿的报道。分期差异可能是由于同时存在头颈部病变，改变了治疗计划，或改变了患者的预后。此类病变几乎不可能在术前诊断，应高度怀疑为晚期癌症。
